Specific learning disorder among primary school children of Sarai Alamgir.

OBJECTIVE: To examine the frequency of specific learning disorder among primary school children. METHODS: The cross-sectional study was conducted from January to July 2018 in Sarai Alamgir, Gujrat, Pakistan, and comprised children studying in 3rd and 4th grades of six local public and private primary schools. Data was collected using structured clinical diagnostic interviews based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. Data was analysed using SPSS 16. RESULTS: Of the 837 subjects, 413(49.3%) were from private schools and 424(50.7%) from public schools. A total of 174(20.7%) children were found vulnerable to specific learning disorders, while 13(7.5%) of them were diagnosed as suffering from different specific learning disorders. Of these 13 subjects, 1(7.7%) child had reading impairment, 3(23.1%) had mathematics impairment, 4(30.8%) had multiple impairment in mathematics and writing, 1(7.7%) had multiple impairment in mathematics and reading, 1(7.7%) had multiple impairment in reading and writing, and 3(23.1%) had multiple impairment in mathematics, reading and writing. CONCLUSIONS: Specific learning disorder was found to be prevailing in public and private school children.

Stress-related growth of HIV/AIDS patients: Role of religion and self-esteem in mitigating perceived discrimination.

OBJECTIVE: Objectives of the present research were to i) examine association between levels of religiosity, self-esteem, perceived discrimination and stress related growth among HIV/AIDS patients and ii) find out the mediating effect of self-esteem on perceived discrimination and stress related growth among HIV/AIDS patients. METHODS: A cross sectional study was conducted on respondents registered in VCCT (Voluntary Confidential Counseling & testing) center at Civil Hospital of Jalal Pur Jattan, Gujrat. Total sample of 247 patients was selected on the basis of two stage stratified simple random sampling technique. After taking verbal consent from respondents, data was collected from HIV/AIDS patients by using a structured questionnaire. Analysis was performed by using SPSS version 21. RESULTS: Results of descriptive analysis showed that majority of respondents belonged to age group 29-37 (39.5%). Educational attainment of majority of the respondents was 6-11 years 95(38.3%), whereas, 27.4% of the respondents had monthly household income between Rs.10001-20000. Religiosity had strong correlation with self-esteem whereas it was negatively correlated with perceived discrimination. Perceived discrimination and level of stress related growth were negatively correlated with each other. CONCLUSIONS: Results of correlation and regression analysis showed that level of religiosity and self-esteem had significant effects in reducing perceived discrimination among HIV/AIDS patients. The reduced perceived discrimination further assisted in improving the stress related growth among respondents.

Watering the Plant in Another's Courtyard: An Ethnographic Exploration of Daughters' Devaluation Through Sex-Selected Abortions Among the Rural Married Females in South Punjab, Pakistan.

The current study sets forth the cultural underpinnings for daughters' devaluation over son preferences in South Punjab, Pakistan. The major purpose of the present study was to provide an accurate description of women's attitude on different aspects of sex-selected abortions (SSAs). Women, with a rural background, either forced to devalue their female fetus clinically or based on violence, were the targeted participants. Using ethnographic exploration with 161 obtrusive observations, 37 in-depth interviews, and 10 focus group discussions (FGD), comprising of 85 narrated case studies, the attitudes of rural married females toward daughters' devaluation through SSAs were recorded. The findings of study allied the autonomy paradigm with a feminist perspective through argumentation of the lack of women's individual identity in the domestic sphere. In addition, sociocultural legitimization toward patriarchal regimes snatches women's autonomy over their reproductive behavior. Resultantly, daughters' devaluation is analogous to sons' preference, which arose through women's subservience and exposure to violence in the intricate cultural web. Using ethnographic exploration through various anthropological research techniques, it explicates the nuanced feminist regimes for understanding women's reproductive choice and empowerment. In conclusion, women's subordination is the cause of differential power relations and inadequate gender inequality which results in SSAs. The current study exposed gender-biased power discrimination that consequently affects the women's autonomous decision making about their reproductive behavior. Similarly, it highlighted how husband and in-laws (especially mother-in-law) used illegal medicines, dietary practices, traditional methods, or new biotechnological methods to execute the illegal act of SSA. This study may serve as the basic legal framework to check the deep-rooted culture of violence against vulnerable segments of the population.

Postpartum depression and suicidal ideation in new mothers with hearing loss: Perceived social support as a moderator, a multicentre study.

OBJECTIVES: To explore postpartum depression as a predictor of suicidal ideation and to find if perceived social support had a moderator effect in this scenario among new mothers with hearing loss. METHODS: The descriptive cross-sectional study was conducted from March to September 2018 in Lahore, Islamabad, Rawalpindi, Gujrat, Gujranwala, Jhelum and Sialkot Cities of Pakistan. New mothers with hearing loss (HL) and those without hearing loss were recruited from maternity clinics 2 to 6 weeks after the delivery. Standardised tools were used to measure postpartum depression, perceived social support and suicidal ideation among the subjects. Data was analysed using SPSS 21. RESULTS: Of the 547subjects, 272(49.7%) were those with hearing loss and 275(50.3%) were without hearing loss. Odd ratio showed that mothers with hearing loss were 1.97 times more likely to exhibit postpartum depression compared to those without hearing loss, whereas participants with HL were 1.08 times more likely to be at risk of having suicidal behaviours compared to those without hearing loss. On the other hand, those without hearing loss were 0.97 times higher on social support. Postpartum depression was a positive predictor (p<0.001) whereas perceived social support negatively (p<0.001) predicted the suicidal ideation of new mothers with hearing loss. The interaction of postpartum depression and perceived social support negatively affected (<0.001) suicidal behaviour. CONCLUSIONS: Perceived social support appeared to lower the probability of postpartum depression and suicidal ideation among mothers with hearing loss.

The impact of information and communication technologies, CO2 emissions, and energy consumption on inclusive development in developing countries.

This study investigates the impact of information and communication technologies, carbon dioxide emissions, and energy consumption on inclusive development of 81 developing countries for the period 2010-2014. Two-step system generalized method of moments has been employed to estimate these dynamic relationships among the variables in conditional and unconditional models. Our findings support the theory that ICTs can be used as policy instrument to dampen the negative effect of environmental degradation on inclusive development. The results suggest that ICTs in association with CO2 emissions per capita positively affect inclusive development in an unconditional regression. When ICT complements CO2 intensity, it positively affects inclusive development in mobile- and internet-oriented regressions. However, we also found net negative effects of association between ICTs and CO2 emissions from liquid and fuel and CO2 emissions from heat and electricity which reflects a decrease in inclusive human development. We suggest that policy makers should consider the nature and dimensions of CO2 emissions while using ICTs as policy instrument to mitigate emissions and should invite and plan such investments in ICTs which help in attaining environmental sustainability and inclusive development.

The Role of Socio-demographics in Adoption of Religious-Spiritual and Other Coping Strategies Among Muslim Chronic Patients with Hepatitis C in Pakistan.

Coping has emerged as a vital indicator among patients in the chronic conditions. The current study examined the role of demographic characteristics (such as age, education, gender, marital status, residential background, family type and number of children) in adoption of coping (emotion-focused, problem-solving, religious-spiritual) strategies for nursing among hepatitis patients. A sample of 500 patients (of hepatitis C) was drawn from five most populous districts (Lahore, Faisalabad, Rawalpindi, Gujranwala and Multan) of Punjab, Pakistan, by using Epi Info software with an alpha level of 0.03. The data were collected using a well-structured multi-sectional interview schedule through multistage proportionate sampling technique. Descriptive analysis, regression analysis and reliability analysis were computed using SPSS (version 21.0). In the overall adoption of coping strategies, lower monthly household income, lower education, rural residences, nuclear family setting and married status were contributing to the adoption of higher coping strategies among Muslim chronic patients with hepatitis C. The results of socio-demographics are also discussed with other coping strategies (such as religious-spiritual coping strategies, problem-solving coping strategies, emotion-focused coping strategies and constructive coping strategies). It was the first quantitative study of adoption of coping strategies among Muslim hepatitis patients in Pakistan. The study highlighted the importance of socio-demographic resources to cope with chronic illness. The empirical findings would start a new discussion from hepatic, counseling and nursing perspective. For terminal patients, these socio-demographic characteristics can serve as a guideline to provide community sources of social support. Medical social workers and healthcare experts need to facilitate the efforts of patients to cope with chronic illness through revision of nursing policy according to the socio-demographic and spiritual-religious needs of the patients.

Correlates of self-reported depressive symptoms: a study of older persons of Punjab, Pakistan.

This paper examines the prevalence and correlates of depressive symptoms among older persons of Punjab, the largest Province of Pakistan. Data were gathered from 4191 older persons aged 60+ using Probability Proportional to Size (PPS) of population. A version of the CES-D Scale adapted for low-literate populations was used to measure self reported depressive symptoms. Various independent factors, including socioeconomic factors, self-reported health conditions, and functional impairments were examined to see their net effect on depressive symptoms among older persons. Results of logistic regression analysis showed that region, area, living index, independent source of income, self-reported health conditions, and functional impairment were significant factors affecting self-reported depressive symptoms among older persons in Punjab. An important cross-cultural difference was a lower risk of depressive symptoms among older women, which may reflect the buffering effects of family co-residence and the position of seniors in extended families.

Prediction model for determining important factors of success of external cephalic version.

BACKGROUND: The External cephalic version (ECV) is a skill as well as an art that could be easily acquired. It has become a valuable option in the management of breech foetus at term. Aims of this study were to determining those factors that were significantly associated with success of external cephalic version (ECV) procedure. METHOD: This prospective interventional study was conducted at Department of Obstetrics and Gynaecology, Unit-III, Services Hospital, Lahore, Pakistan from July 2007 to December 2009. Total of 56 patients who had undergone ECV was analysed descriptively and analytically. Univariate and multivariate data analysis was performed. Pre-procedural factors (gravidity, gestational age, amniotic fluid index, placental location, type of breech, maternal obesity, foetal weight), and factors associated with the procedure itself (abdominal wall musculature tone, uterine tone, maternal anxiety, maternal threshold for pain, engagement of breech, number of attempts) were assessed. RESULTS: Thirty-three patients were successfully converted to vertex presentation. In multivariate analysis, placenta, type of breach, station of breach and number of attempts (< or = 2 times) were significantly associated factors with ECV procedure. CONCLUSION: ECV is most likely to succeed when the patient has already one pregnancy and child birth, the breech is not engaged, and is flexed. Procedure is usually successful within one or two attempts, whereas ongoing attempts lead to increased maternal anxiety, lesser cooperation and ending in failure.